TY - JOUR
T1 - Exercise Performance and Quality of Life of Left Ventricular Assist Device Patients After Long-Term Outpatient Cardiac Rehabilitation
AU - Schlöglhofer, Thomas
AU - Gross, Christoph
AU - Moscato, Francesco
AU - Neumayer, Alexander
AU - Kandioler, Elisabeth
AU - Leithner, Daniela
AU - Skoumal, Martin
AU - Laufer, Günther
AU - Wiedemann, Dominik
AU - Schima, Heinrich
AU - Zimpfer, Daniel
AU - Marko, Christiane
N1 - Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023/9/1
Y1 - 2023/9/1
N2 - Purpose: Exercise performance and quality of life (QoL) of left ventricular assist device (LVAD) patients improve after early cardiac rehabilitation (CR). The purpose of this study was to examine the efficacy of multiprofessional long term phase 3 outpatient CR, and whether cardiopulmonary exercise testing (CPX) and 6-min walk testing (6MWT) post-LVAD implantation predict hospital readmission. Methods: This retrospective observational cohort study included 29 LVAD patients (58.6 ± 7.7 yr, female: 13.8%, body mass index: 29.4 ± 3.3 kg/m2). Functional performance tests (CPX, 6MWT, sit-to-stand test), QoL, and psychological surveys (Kansas City Cardiomyopathy Questionnaire, hospital anxiety and depression scale, and Control Convictions about Disease and Health [KKG]) were performed at baseline and at the end of CR. Results: The CR was initiated at a median (IQR) of 159 (130-260) d after LVAD implantation for a duration of 340 (180-363) d with 46.8 ± 23.2 trainings. The 6MWT (408.4 ± 113.3 vs 455.4 ± 115.5 m, P =.003) and sit-to-stand test (16.7 ± 6.9 vs 19.0 ± 5.3 repetitions, P =.033) improved, but relative peak oxygen uptake (V˙o2peak: 9.4 [8.2-14.4] vs 9.3 [7.8-13.4] mL/min/kg, P =.57) did not change. Using receiver operating characteristic curve analysis, baseline V˙o2peakvalues were associated with readmission 1-yr after CR onset (C-statistic = 0.88) with a cutoff value of V˙o2peak< 9.15 mL/min/kg (100% sensitivity, 78% specificity, P <.001). The Kansas City Cardiomyopathy Questionnaire self-efficacy and knowledge (+6.3 points), QoL (+5.0 points), and social limitation (+7.1 points) demonstrated clinically important changes. In addition, the hospital anxiety and depression scale showed a significant reduction in anxiety (4.6 ± 3.2 vs 2.6 ± 2.4, P =.03). Conclusions: Long-term CR is safe and LVAD outpatients showed improvement of QoL, anxiety, and submaximal exercise performance. In addition, V˙o2peakand 6MWT have prognostic value for readmission.
AB - Purpose: Exercise performance and quality of life (QoL) of left ventricular assist device (LVAD) patients improve after early cardiac rehabilitation (CR). The purpose of this study was to examine the efficacy of multiprofessional long term phase 3 outpatient CR, and whether cardiopulmonary exercise testing (CPX) and 6-min walk testing (6MWT) post-LVAD implantation predict hospital readmission. Methods: This retrospective observational cohort study included 29 LVAD patients (58.6 ± 7.7 yr, female: 13.8%, body mass index: 29.4 ± 3.3 kg/m2). Functional performance tests (CPX, 6MWT, sit-to-stand test), QoL, and psychological surveys (Kansas City Cardiomyopathy Questionnaire, hospital anxiety and depression scale, and Control Convictions about Disease and Health [KKG]) were performed at baseline and at the end of CR. Results: The CR was initiated at a median (IQR) of 159 (130-260) d after LVAD implantation for a duration of 340 (180-363) d with 46.8 ± 23.2 trainings. The 6MWT (408.4 ± 113.3 vs 455.4 ± 115.5 m, P =.003) and sit-to-stand test (16.7 ± 6.9 vs 19.0 ± 5.3 repetitions, P =.033) improved, but relative peak oxygen uptake (V˙o2peak: 9.4 [8.2-14.4] vs 9.3 [7.8-13.4] mL/min/kg, P =.57) did not change. Using receiver operating characteristic curve analysis, baseline V˙o2peakvalues were associated with readmission 1-yr after CR onset (C-statistic = 0.88) with a cutoff value of V˙o2peak< 9.15 mL/min/kg (100% sensitivity, 78% specificity, P <.001). The Kansas City Cardiomyopathy Questionnaire self-efficacy and knowledge (+6.3 points), QoL (+5.0 points), and social limitation (+7.1 points) demonstrated clinically important changes. In addition, the hospital anxiety and depression scale showed a significant reduction in anxiety (4.6 ± 3.2 vs 2.6 ± 2.4, P =.03). Conclusions: Long-term CR is safe and LVAD outpatients showed improvement of QoL, anxiety, and submaximal exercise performance. In addition, V˙o2peakand 6MWT have prognostic value for readmission.
KW - Humans
KW - Female
KW - Cardiac Rehabilitation
KW - Quality of Life
KW - Outpatients
KW - Retrospective Studies
KW - Heart-Assist Devices
KW - Cardiomyopathies
KW - Heart Failure
UR - https://www.scopus.com/pages/publications/85168789519
U2 - 10.1097/HCR.0000000000000789
DO - 10.1097/HCR.0000000000000789
M3 - Journal article
C2 - 37014949
SN - 1932-7501
VL - 43
SP - 346
EP - 353
JO - Journal of Cardiopulmonary Rehabilitation and Prevention
JF - Journal of Cardiopulmonary Rehabilitation and Prevention
IS - 5
ER -